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Good MedicalPractice
Guidance
fordoctors
The duties of a doctor registered withthe General Medical Council
Patients must be able to trust doctors with their lives and health. To justify that trust
you must show respect for human life and you must:
Make the care of your patient your first concern
Protect and promote the health of patients and the public
Provide a good standard of practice and care
- Keep your professional knowledge and skills up to date
- Recognise and work within the limits of your competence
- Work with colleagues in the ways that best serve patients’ interests
Treat patients as individuals and respect their dignity
- Treat patients politely and considerately
- Respect patients’ right to confidentiality
Work in partnership with patients
- Listen to patients and respond to their concerns and preferences
- Give patients the information they want or need in a way they can understand
- Respect patients’ right to reach decisions with you about their treatment
and care
- Support patients in caring for themselves to improve and maintain their health
Be honest and open and act with integrity
- Act without delay if you have good reason to believe that you or a colleague
may be putting patients at risk
- Never discriminate unfairly against patients or colleagues
- Never abuse your patients’ trust in you or the public’s trust in the profession.
You are personally accountable for your professional practice and must always be
prepared to justify your decisions and actions.
Good Medical Practice
General Medical Council 01
Good Medical Practice
Good Medical Practice came into effect on 13 November 2006.
Paragraph(s) Pages
About Good Medical Practice 4
How Good Medical Practice applies to you 5
Good doctors 1 6
Good clinical care 2–11 7
Providing good clinical care 2–3 7
Supporting self-care 4 9
Avoid treating those close to you 5 9
Raising concerns about patient safety 6 9
Decisions about access to medical care 7–10 10
Treatment in emergencies 11 11
Maintaining good medical practice 12–14 12
Keeping up to date 12–13 12
Maintaining and improving your performance 14 13
Teaching and training, appraising
and assessing 15–19 14
Relationships with patients 20–40 15
The doctor-patient partnership 20–21 15
Good communication 22–23 16
Children and young people 24–28 17
Relatives, carers and partners 29 18
Being open and honest with patients
if things go wrong 30–31 18
Maintaining trust in the profession 32–35 19
Consent 36 20
Confidentiality 37 20
Ending your professional relationship
with a patient 38–40 21
Good Medical Practice
02 General Medical Council
Contents
Paragraph(s) Pages
Working with colleagues 41–55 22
Working in teams 41–42 22
Conduct and performance of colleagues 43–45 23
Respect for colleagues 46–47 24
Arranging cover 48 24
Taking up and ending appointments 49 25
Sharing information with colleagues 50–53 25
Delegation and referral 54–55 26
Probity 56–76 27
Being honest and trustworthy 56–59 27
Providing and publishing information
about your services 60–62 28
Writing reports and CVs, giving evidence
and signing documents 63–69 28
Research 70–71 30
Financial and commercial dealings 72–73 31
Conflicts of interest 74–76 33
Health 77–79 34
Further reading 36
Endnotes 39
Index 42
Good Medical Practice
General Medical Council 03
Contents
GoodMedical Practice sets out the principles and values on which
good practice is founded; these principles together describe medical
professionalism in action. The guidance is addressed to doctors, but it is
also intended to let the public knowwhat they can expect from doctors.
We have provided links* to other guidance and information which
illustrate how the principles in Good Medical Practice apply in
practice, and how they may be interpreted in other contexts; for
example, in undergraduate education, in revalidation, or in our
consideration of a doctor’s conduct, performance or health through
our fitness to practise procedures. There are links to:
supplementary guidance and other information from the GMC
cases heard by GMC fitness to practise panels, which provide
examples of where a failure to follow the guidance in
Good Medical Practice has put a doctor’s registration at risk
(available on-line only)
external (non-GMC) sources of advice and information.
You can access all these documents on our website, or order
printed versions of the GMC documents by contacting
[email protected] (phone: 0161 923 6315).
*Please check the GMC website for the most up-to-date links:www.gmc-uk.org/guidance
Good Medical Practice
04 General Medical Council
About Good Medical Practice
The guidance that follows describes what is expected of all doctors
registered with the GMC. It is your responsibility to be familiar with
Good Medical Practice and to follow the guidance it contains. It is
guidance, not a statutory code, so you must use your judgement
to apply the principles to the various situations you will face as
a doctor, whether or not you hold a licence to practise and
whether or not you routinely see patients. You must be prepared
to explain and justify your decisions and actions.
In Good Medical Practice the terms ‘you must’ and ‘you should’ are
used in the following ways:
‘You must’ is used for an overriding duty or principle.
‘You should’ is used when we are providing an explanation of
how you will meet the overriding duty.
‘You should’ is also used where the duty or principle will not
apply in all situations or circumstances, or where there are
factors outside your control that affect whether or how you can
comply with the guidance.
Serious or persistent failure to follow this guidance will put your
registration at risk.
Good Medical Practice
General Medical Council 05
HowGoodMedical Practice applies to you
See GMCguidance onthe meaningof fitness topractise
Good Doctors
1 Patients need good doctors. Good doctors make the care
of their patients their first concern: they are competent,
keep their knowledge and skills up to date, establish and
maintain good relationships with patients and colleagues*,
are honest and trustworthy, and act with integrity.
Good Medical Practice
06 General Medical Council
* Those a doctor works with, whether or not they are also doctors.
Providing good clinical care
2 Good clinical care must include:
(a) adequately assessing the patient’s conditions, taking
account of the history (including the symptoms, and
psychological and social factors), the patient’s views,
and where necessary examining the patient
(b) providing or arranging advice, investigations or treatment
where necessary
(c) referring a patient to another practitioner, when this is
in the patient’s best interests.
Good Medical Practice
General Medical Council 07
Good clinical care
2b. Seeparagraph 21band GMCconsentguidance
3 In providing care you must:
(a) recognise and work within the limits of your competence
(b) prescribe drugs or treatment, including repeat prescriptions,
only when you have adequate knowledge of the patient’s
health, and are satisfied that the drugs or treatment serve
the patient’s needs
(c) provide effective treatments based on the best
available evidence
(d) take steps to alleviate pain and distress whether or not
a cure may be possible
(e) respect the patient’s right to seek a second opinion
(f) keep clear, accurate and legible records, reporting the
relevant clinical findings, the decisions made, the
information given to patients, and any drugs prescribed
or other investigation or treatment
(g) make records at the same time as the events you are
recording or as soon as possible afterwards
(h) be readily accessible when you are on duty
(i) consult and take advice from colleagues, when appropriate
(j) make good use of the resources available to you.
Good Medical Practice
08 General Medical Council
3b. See GMCprescribingguidanceparagraph 40
3d. Seeparagraph 21band GMCguidance ontreatment andcare towardsthe end of life
3j. See GMCmanagementguidance
Supporting self-care
4 You should encourage patients and the public to take an
interest in their health and to take action to improve and
maintain it. This may include advising patients on the effects
of their life choices on their health and well-being and the
possible outcomes of their treatments.
Avoid treating those close to you
5 Wherever possible, you should avoid providing medical care
to anyone with whom you have a close personal relationship.
Raising concerns about patient safety
6 If you have good reason to think that patient safety is or
may be seriously compromised by inadequate premises,
equipment, or other resources, policies or systems, you
should put the matter right if that is possible. In all other
cases you should draw the matter to the attention of your
employing or contracting body. If they do not take adequate
action, you should take independent advice on how to take
the matter further. You must record your concerns and the
steps you have taken to try to resolve them.
Good Medical Practice
General Medical Council 09
6. Seeparagraphs43–45, GMCmanagementguidance, andGMCguidance onraisingconcerns
5. Seeparagraph 77and GMCprescribingguidanceparagraphs 4and 13 –16
4. Seeendnote 1
Decisions about access to medical care
7 The investigations or treatment you provide or arrange must be
based on the assessment you and the patient make of their needs
and priorities, and on your clinical judgement about the likely
effectiveness of the treatment options. You must not refuse or
delay treatment because you believe that a patient’s actions have
contributed to their condition. You must treat your patients with
respect whatever their life choices and beliefs. You must not
unfairly discriminate against them by allowing your personal
views* to affect adversely your professional relationship with
them or the treatment you provide or arrange. You should
challenge colleagues if their behaviour does not comply with
this guidance.
8 If carrying out a particular procedure or giving advice about it
conflicts with your religious or moral beliefs, and this conflict
might affect the treatment or advice you provide, you must
explain this to the patient and tell them they have the right to
see another doctor. You must be satisfied that the patient has
sufficient information to enable them to exercise that right. If it
is not practical for a patient to arrange to see another doctor,
you must ensure that arrangements are made for another
suitably qualified colleague to take over your role.
Good Medical Practice
10 General Medical Council
7. See GMCguidance onpersonalbeliefs andGMCguidance onvaluingdiversity
8. See GMCguidance onpersonalbeliefs
* This includes your views about a patient’s age, colour, culture, disability, ethnic ornational origin, gender, lifestyle, marital or parental status, race, religion or beliefs,sex, sexual orientation, or social or economic status.
9 You must give priority to the investigation and treatment
of patients on the basis of clinical need, when such decisions
are within your power. If inadequate resources, policies or
systems prevent you from doing this, and patient safety is or
may be seriously compromised, you must follow the guidance
in paragraph 6.
10 All patients are entitled to care and treatment to meet their
clinical needs. You must not refuse to treat a patient because
their medical condition may put you at risk. If a patient poses
a risk to your health or safety, you should take all available
steps to minimise the risk before providing treatment or
making suitable alternative arrangements for treatment.
Treatment in emergencies
11 In an emergency, wherever it arises, you must offer
assistance, taking account of your own safety, your
competence, and the availability of other options for care.
Good Medical Practice
General Medical Council 11
9. Seeparagraph 6
Keeping up to date
12 You must keep your knowledge and skills up to date throughout
your working life. You should be familiar with relevant guidelines
and developments that affect your work. You should regularly
take part in educational activities that maintain and further
develop your competence and performance.
13 You must keep up to date with, and adhere to, the laws and
codes of practice relevant to your work.
Good Medical Practice
12 General Medical Council
12. See GMCguidance oncontinuingprofessionaldevelopmentand endnote 2
Maintaining good medical practice
Maintaining and improving your performance
14 You must work with colleagues and patients to maintain and
improve the quality of your work and promote patient safety.
In particular, you must:
(a) maintain a folder of information and evidence,
drawn from your medical practice
(b) reflect regularly on your standards of medical practice
in accordance with GMC guidance on licensing
and revalidation
(c) take part in regular and systematic audit
(d) take part in systems of quality assurance and
quality improvement
(e) respond constructively to the outcome of audit, appraisals
and performance reviews, undertaking further training
where necessary
(f) help to resolve uncertainties about the effects
of treatments
(g) contribute to confidential inquiries and adverse event
recognition and reporting, to help reduce risk to patients
(h) report suspected adverse drug reactions in accordance
with the relevant reporting scheme
(i) co-operate with legitimate requests for information
from organisations monitoring public health –
when doing so you must follow the guidance in
Confidentiality.
Good Medical Practice
General Medical Council 13
14e. Seeendnote 3
14g. Seeendnote 4
14h. See GMCprescribingguidance andendnote 5
14i. See GMCconfidentialityguidance
14a, b.See GMCGMPframeworkdocument.
15 Teaching, training, appraising and assessing doctors and
students are important for the care of patients now and in the
future. You should be willing to contribute to these activities.
16 If you are involved in teaching you must develop the skills,
attitudes and practices of a competent teacher.
17 You must make sure that all staff for whom you are responsible,
including locums and students, are properly supervised.
18 You must be honest and objective when appraising or assessing
the performance of colleagues, including locums and students.
Patients will be put at risk if you describe as competent
someone who has not reached or maintained a satisfactory
standard of practice.
19 You must provide only honest, justifiable and accurate
comments when giving references for, or writing reports
about, colleagues. When providing references you must do so
promptly and include all information that is relevant to your
colleague’s competence, performance or conduct.
Good Medical Practice
14 General Medical Council
Teaching and training, appraisingand assessing
19. Seeparagraph 63and GMCguidance onwritingreferences
The doctor-patient partnership
20 Relationships based on openness, trust and good communication
will enable you to work in partnership with your patients to
address their individual needs.
21 To fulfil your role in the doctor-patient partnership you must:
(a) be polite, considerate and honest
(b) treat patients with dignity
(c) treat each patient as an individual
(d) respect patients’ privacy and right to confidentiality
(e) support patients in caring for themselves to improve and
maintain their health
(f) encourage patients who have knowledge about their
condition to use this when they are making decisions
about their care.
Good Medical Practice
General Medical Council 15
Relationships with patients
21b. See GMCguidance onmaintainingboundaries
21d. See GMCconfidentialityguidance
21e. Seeendnote 1
Good communication
22 To communicate effectively you must:
(a) listen to patients, ask for and respect their views
about their health, and respond to their concerns
and preferences
(b) share with patients, in a way they can understand, the
information they want or need to know about their
condition, its likely progression, and the treatment
options available to them, including associated risks
and uncertainties
(c) respond to patients’ questions and keep them informed
about the progress of their care
(d) make sure that patients are informed about how
information is shared within teams and among those
who will be providing their care.
23 You must make sure, wherever practical, that arrangements
are made to meet patients’ language and communication
needs.
Good Medical Practice
16 General Medical Council
22b. See GMCconsentguidanceparagraphs7-36
22d. See GMCconfidentialityguidanceparagraph 7,and 25-32
23. See GMCconsentguidanceparagraph 21
Children and young people
24 The guidance that follows in paragraphs 25–27 is relevant
whether or not you routinely see children and young people
as patients. You should be aware of the needs and welfare of
children and young people when you see patients who are
parents or carers, as well as any patients who may represent
a danger to children or young people.
25 You must safeguard and protect the health and well-being of
children and young people.
26 You should offer assistance to children and young people if
you have reason to think that their rights have been abused or
denied.
27 When communicating with a child or young person you must:
(a) treat them with respect and listen to their views
(b) answer their questions to the best of your ability
(c) provide information in a way they can understand.
28 The guidance in paragraphs 25–27 is about children and
young people, but the principles also apply to other
vulnerable groups.
Good Medical Practice
General Medical Council 17
24. See GMC0-18 guidance
See endnote 6
Relatives, carers and partners
29 You must be considerate to relatives, carers, partners and
others close to the patient, and be sensitive and responsive in
providing information and support, including after a patient
has died. In doing this you must follow the guidance in
Confidentiality.
Being open and honest with patients if thingsgo wrong
30 If a patient under your care has suffered harm or distress, you
must act immediately to put matters right, if that is possible.
You should offer an apology and explain fully and promptly to
the patient what has happened, and the likely short-term and
long-term effects.
31 Patients who complain about the care or treatment they have
received have a right to expect a prompt, open, constructive
and honest response including an explanation and, if
appropriate, an apology. You must not allow a patient’s
complaint to affect adversely the care or treatment you
provide or arrange.
Good Medical Practice
18 General Medical Council
29. See endnote7 and GMCconfidentialityguidanceincludingparagraphs 64-66
30. Seeendnote 8
Maintaining trust in the profession
32 You must not use your professional position to establish
or pursue a sexual or improper emotional relationship with
a patient or someone close to them.
33 You must not express to your patients your personal beliefs,
including political, religious or moral beliefs, in ways that
exploit their vulnerability or that are likely to cause
them distress.
34 You must take out adequate insurance or professional
indemnity cover for any part of your practice not covered by
an employer’s indemnity scheme, in your patients’ interests
as well as your own.
35 You must be familiar with your GMC reference number.
You must make sure you are identifiable to your patients
and colleagues, for example by using your registered name
when signing statutory documents, including prescriptions.
You must make your registered name and GMC reference
number available to anyone who asks for them.
Good Medical Practice
General Medical Council 19
32. See GMCguidance onmaintainingboundaries
33. See GMCguidance onpersonalbeliefs
35. See GMCguidance onreferencenumbers
Consent
36 You must be satisfied that you have consent or other valid
authority before you undertake any examination or
investigation, provide treatment or involve patients in teaching
or research. Usually this will involve providing information to
patients in a way they can understand, before asking for their
consent. You must follow the guidance in Seeking patients’
consent: The ethical considerations, which includes advice
on children and patients who are not able to give consent.
Confidentiality
37 Patients have a right to expect that information about them
will be held in confidence by their doctors. You must treat
information about patients as confidential, including after
a patient has died. If you are considering disclosing
confidential information without a patient’s consent, you
must follow the guidance in Confidentiality.
Good Medical Practice
20 General Medical Council
36. See GMCconsentguidance andGMC researchguidanceparagraphs15–29
37. See GMCconfidentialityguidance
Ending your professional relationship witha patient
38 In rare circumstances, the trust between you and a patient
may break down, and you may find it necessary to end the
professional relationship. For example, this may occur if a
patient has been violent to you or a colleague, has stolen
from the premises, or has persistently acted inconsiderately
or unreasonably. You should not end a relationship with
a patient solely because of a complaint the patient has
made about you or your team, or because of the resource
implications* of the patient’s care or treatment.
39 Before you end a professional relationship with a patient,
you must be satisfied that your decision is fair and does
not contravene the guidance in paragraph 7. You must be
prepared to justify your decision. You should inform the
patient of your decision and your reasons for ending the
professional relationship, wherever practical in writing.
40 You must take steps to ensure that arrangements are made
promptly for the continuing care of the patient, and you
must pass on the patient’s records without delay.
Good Medical Practice
General Medical Council 21
* If you charge fees, you may refuse further treatment for patients unable orunwilling to pay for services you have already provided. You must follow theguidance in paragraph 39.
39. Seeparagraph 7
Working in teams
41 Most doctors work in teams with colleagues from other
professions. Working in teams does not change your personal
accountability for your professional conduct and the care you
provide. When working in a team, you should act as a positive
role model and try to motivate and inspire your colleagues.
You must:
(a) respect the skills and contributions of your colleagues
(b) communicate effectively with colleagues within and
outside the team
(c) make sure that your patients and colleagues understand
your role and responsibilities in the team, and who is
responsible for each aspect of patient care
(d) participate in regular reviews and audit of the standards
and performance of the team, taking steps to remedy
any deficiencies
(e) support colleagues who have problems with performance,
conduct or health.
42 If you are responsible for leading a team, you must follow the
guidance in Management for doctors.
Good Medical Practice
22 General Medical Council
Working with colleagues
42. See GMCmanagementguidance
41. Seeendnote 9
Conduct and performance of colleagues
43 You must protect patients from risk of harm posed by another
colleague’s conduct, performance or health. The safety of
patients must come first at all times. If you have concerns
that a colleague may not be fit to practise, you must take
appropriate steps without delay, so that the concerns are
investigated and patients protected where necessary. This means
you must give an honest explanation of your concerns to an
appropriate person from your employing or contracting body,
and follow their procedures.
44 If there are no appropriate local systems, or local systems do
not resolve the problem, and you are still concerned about the
safety of patients, you should inform the relevant regulatory
body. If you are not sure what to do, discuss your concerns
with an impartial colleague or contact your defence body,
a professional organisation, or the GMC for advice.
45 If you have management responsibilities you should make
sure that systems are in place through which colleagues can
raise concerns about risks to patients, and you must follow
the guidance in Management for doctors.
Good Medical Practice
General Medical Council 23
43. SeeGMCconfidentialityguidanceparagraph 20 andConfidentiality:Disclosinginformation aboutseriouscommunicablediseasesparagraphs 4-5,and the followingGMC guidance on:referring a doctor,raising concerns,andmanagement
44. See GMCguidance onraisingconcerns
45. See GMCmanagementguidance
Respect for colleagues
46 You must treat your colleagues fairly and with respect.
You must not bully or harass them, or unfairly discriminate
against them by allowing your personal views* to affect
adversely your professional relationship with them. You
should challenge colleagues if their behaviour does not
comply with this guidance.
47 You must not make malicious and unfounded criticisms of
colleagues that may undermine patients’ trust in the care
or treatment they receive, or in the judgement of those
treating them.
Arranging cover
48 You must be satisfied that, when you are off duty, suitable
arrangements have been made for your patients’ medical
care. These arrangements should include effective hand-over
procedures, involving clear communication with healthcare
colleagues. If you are concerned that the arrangements are
not suitable, you should take steps to safeguard patient care
and you must follow the guidance in paragraph 6.
Good Medical Practice
24 General Medical Council
46. See GMCguidance onvaluingdiversity
* This includes your views about a colleague’s age, colour, culture, disability, ethnic ornational origin, gender, lifestyle, marital or parental status, race, religion or beliefs,sex, sexual orientation, or social or economic status.
48. Seeparagraph 6
Taking up and ending appointments
49 Patient care may be compromised if there is not sufficient
medical cover. Therefore, you must take up any post,
including a locum post, you have formally accepted, and
you must work your contractual notice period, unless the
employer has reasonable time to make other arrangements.
Sharing information with colleagues
50 Sharing information with other healthcare professionals is
important for safe and effective patient care.
51 When you refer a patient, you should provide all relevant
information about the patient, including their medical
history and current condition.
52 If you provide treatment or advice for a patient, but are not
the patient’s general practitioner, you should tell the general
practitioner the results of the investigations, the treatment
provided and any other information necessary for the
continuing care of the patient, unless the patient objects.
53 If a patient has not been referred to you by a general
practitioner, you should ask for the patient’s consent to inform
their general practitioner before starting treatment, except
in emergencies or when it is impractical to do so. If you do
not inform the patient’s general practitioner, you will be
responsible for providing or arranging all necessary after-care.
Good Medical Practice
General Medical Council 25
50. See endnote9 and GMCconfidentialityguidanceparagraphs 25-32
49. See GMCappointmentsguidance
Delegation and referral
54 Delegation involves asking a colleague to provide treatment
or care on your behalf. Although you will not be accountable
for the decisions and actions of those to whom you delegate,
you will still be responsible for the overall management of the
patient, and accountable for your decision to delegate. When
you delegate care or treatment you must be satisfied that the
person to whom you delegate has the qualifications,
experience, knowledge and skills to provide the care or
treatment involved. You must always pass on enough
information about the patient and the treatment they need.
55 Referral involves transferring some or all of the responsibility
for the patient’s care, usually temporarily and for a particular
purpose, such as additional investigation, care or treatment
that is outside your competence. You must be satisfied that
any healthcare professional to whom you refer a patient is
accountable to a statutory regulatory body or employed
within a managed environment. If they are not, the transfer of
care will be regarded as delegation, not referral. This means
you remain responsible for the overall management of the
patient, and accountable for your decision to delegate.
Good Medical Practice
26 General Medical Council
Being honest and trustworthy
56 Probity means being honest and trustworthy, and acting with
integrity: this is at the heart of medical professionalism.
57 You must make sure that your conduct at all times justifies
your patients’ trust in you and the public’s trust
in the profession.
58 You must inform the GMC without delay if, anywhere in the
world, you have accepted a caution, been charged with or
found guilty of a criminal offence, or if another professional
body has made a finding against your registration as a result
of fitness to practise procedures.
59 If you are suspended by an organisation from a medical post,
or have restrictions placed on your practice you must, without
delay, inform any other organisations for which you undertake
medical work and any patients you see independently.
Good Medical Practice
General Medical Council 27
Probity
58. See GMCguidance onreportingconvictions
Providing and publishing information aboutyour services
60 If you publish information about your medical services, you
must make sure the information is factual and verifiable.
61 You must not make unjustifiable claims about the quality or
outcomes of your services in any information you provide to
patients. It must not offer guarantees of cures, nor exploit
patients’ vulnerability or lack of medical knowledge.
62 You must not put pressure on people to use a service, for
example by arousing ill-founded fears for their future health.
Writing reports and CVs, giving evidence andsigning documents
63 You must be honest and trustworthy when writing reports,
and when completing or signing forms, reports and
other documents.
64 You must always be honest about your experience,
qualifications and position, particularly when applying for posts.
65 You must do your best to make sure that any documents you
write or sign are not false or misleading. This means that you
must take reasonable steps to verify the information in the
documents, and that you must not deliberately leave out
relevant information.
Good Medical Practice
28 General Medical Council
63. Seeendnote 11
65. See GMCguidance onwritingreferences
66 If you have agreed to prepare a report, complete or sign
a document or provide evidence, you must do so without
unreasonable delay.
67 If you are asked to give evidence or act as a witness in
litigation or formal inquiries, you must be honest in all your
spoken and written statements. You must make clear the
limits of your knowledge or competence.
68 You must co-operate fully with any formal inquiry into the
treatment of a patient and with any complaints procedure that
applies to your work. You must disclose to anyone entitled to
ask for it any information relevant to an investigation into your
own or a colleague’s conduct, performance or health. In doing
so, you must follow the guidance in Confidentiality.
69 You must assist the coroner or procurator fiscal in an inquest
or inquiry into a patient’s death by responding to their
enquiries and by offering all relevant information. You are
entitled to remain silent only when your evidence may lead to
criminal proceedings being taken against you.
Good Medical Practice
General Medical Council 29
67. Seeparagraph 3aand GMCguidance onexpertwitnesses
68. See GMCconfidentialityguidance
69. See GMCconfidentialityguidance
Research
70 Research involving people directly or indirectly is vital in
improving care and reducing uncertainty for patients now
and in the future, and improving the health of the population
as a whole.
71 If you are involved in designing, organising or carrying out
research, you must:
(a) put the protection of the participants’ interests first
(b) act with honesty and integrity
(c) follow the appropriate national research governance
guidelines and the guidance in Research: The role and
responsibilities of doctors.
Good Medical Practice
30 General Medical Council
71c. See GMCresearchguidance andendnote 12
Financial and commercial dealings
72 You must be honest and open in any financial arrangements
with patients. In particular:
(a) you must inform patients about your fees and charges,
wherever possible before asking for their consent
to treatment
(b) you must not exploit patients' vulnerability or lack of
medical knowledge when making charges for treatment
or services
(c) you must not encourage patients to give, lend or
bequeath money or gifts that will directly or indirectly
benefit you
(d) you must not put pressure on patients or their families
to make donations to other people or organisations
(e) you must not put pressure on patients to accept
private treatment
(f) if you charge fees, you must tell patients if any part
of the fee goes to another healthcare professional.
Good Medical Practice
General Medical Council 31
72. See GMCguidance onconflicts ofinterest
73 You must be honest in financial and commercial dealings with
employers, insurers and other organisations or individuals.
In particular:
(a) before taking part in discussions about buying or selling
goods or services, you must declare any relevant financial
or commercial interest that you or your family might
have in the transaction
(b) if you manage finances, you must make sure the funds are
used for the purpose for which they were intended and are
kept in a separate account from your personal finances.
Good Medical Practice
32 General Medical Council
Conflicts of interest
74 You must act in your patients’ best interests when making
referrals and when providing or arranging treatment or care.
You must not ask for or accept any inducement, gift or
hospitality which may affect or be seen to affect the way
you prescribe for, treat or refer patients. You must not offer
such inducements to colleagues.
75 If you have financial or commercial interests in organisations
providing healthcare or in pharmaceutical or other biomedical
companies, these interests must not affect the way you
prescribe for, treat or refer patients.
76 If you have a financial or commercial interest in an
organisation to which you plan to refer a patient for
treatment or investigation, you must tell the patient about
your interest. When treating NHS patients you must also
tell the healthcare purchaser.
Good Medical Practice
General Medical Council 33
74. See GMCguidance onconflicts ofinterest andendnote 13
75. See GMCprescribingguidanceparagraphs10–12
77 You should be registered with a general practitioner outside
your family to ensure that you have access to independent
and objective medical care. You should not treat yourself.
78 You should protect your patients, your colleagues and
yourself by being immunised against common serious
communicable diseases where vaccines are available.
79 If you know that you have, or think that you might have,
a serious condition that you could pass on to patients,
or if your judgement or performance could be affected by
a condition or its treatment, you must consult a suitably
qualified colleague. You must ask for and follow their advice
about investigations, treatment and changes to your practice
that they consider necessary. You must not rely on your own
assessment of the risk you pose to patients.
Good Medical Practice
34 General Medical Council
Health
78. Seeendnote 14and GMCmanagementguidanceparagraphs58–59
77. Seeparagraph 5and GMCprescribingguidanceparagraphs 4and 13–16
Good Medical Practice
References
General Medical Council 35
Good Medical Practice
For the most up-to-date guidance visit
our website www.gmc-uk.org/
guidance.
Supporting ethical guidancefrom the GMC
This guidance expands upon the principles
in GoodMedical Practice to show how the
principles apply in practice:
0-18 years: guidance for all doctors
(2007)
Accountability in multi-disciplinary and
multi-agency mental health teams
(2005)
Acting as an expert witness (2008)
Confidentiality (2009) including seven
pieces of supplementary guidance
Conflicts of interest (2006)
Consent: patients and doctors making
decisions together (2008)
Good practice in prescribing medicines
(2008)
Good practice in research andConsent to
research (2010)
Maintaining boundaries (2006)
Management for doctors (2006)
Personal beliefs and medical practice
(2008)
Raising concerns about patient safety
(2006)
Reporting criminal and regulatory
proceedings within and outside the UK
(2008)
Taking up and ending appointments
(2008)
Treatment and care towards the end of
life: good practice in decision making
(2010)
Writing references (2007)
36 General Medical Council
Further reading
Good Medical Practice
General Medical Council 37
Other GMC publications
Guidance on continuing professional
development (2004)
GMP – a working framework for appraisal
and assessment (2008)
Guidance for doctors on using registered
name andGMC reference number
(2006)
Indicative Sanctions Guidance for the
Fitness to Practice Panel (2009)
Referring a doctor to theGMC: A guide
for individual doctors, medical directors
and clinical governance managers (see
www.gmc-uk.org/concerns)
The meaning of fitness to practise
(2005)
Valuingdiversity – resource guides
(2006)
Royal College andother guidance
The following documents were written
to contribute to the process of
revalidation by describing what is
expected of doctors in these specialties.
Some of these documents are under
review; you can check their current
status with the colleges.
Good Practice: AGuide for Departments
of Anaesthesia, Critical Care and Pain
Management, Royal College of
Anaesthetists, 3rd edition,
October 2006
Good Medical Practice in Cosmetic
Surgery/Procedures, Independent
Healthcare Advisory Services, May 2006
Good Practice in Dental Specialties,
Senate of Dental Specialties, 2004
Supplement toGood Medical Practice,
Disability Rights Commission, 2007
Good Medical Practice for General
Practitioners, Royal College of General
Practitioners, July 2008
Good Medical Practice
Revalidation inObstetrics and
Gynaecology: Criteria, Standards and
Evidence, Royal College of Obstetricians
and Gynaecologists, July 2002
Guidance for Revalidation and Appraisal
inOphthalmology – Criteria, Standards
and Evidence, Royal College of
Ophthalmologists, May 2003
Good Medical Practice in Paediatrics and
Child Health: Duties and Responsibilities
of Paediatricians, Royal College of
Paediatrics and Child Health, May 2002
Good Medical Practice in Pathology,
Royal College of Pathology, July 2002
Good Medical Practice for Physicians,
Federation of Royal College of
Physicians of the UK, 2004
Good Psychiatric Practice, Royal College
of Psychiatrists, 2nd edition,
November 2004
Individual Responsibilities – AGuide to
Good Medical Practice for Radiologists,
Royal College of Radiologists, May 2004
Good Surgical Practice, Royal College of
Surgeons of England, February 2008
Good Medical Practice forOccupational
Physicians, Faculty of Occupational
Medicine, 2001
Good Public Health Practice: Standards
for Public Health Physicians and
Specialists in Training, Faculty of Public
Health Medicine, April 2001
Good Pharmaceutical Medical Practice,
Faculty of Pharmaceutical Medicine,
2003
Guidelines on Revalidation: Criteria,
Standards and Evidence, College of
Emergency Medicine, 2006
38 General Medical Council
Good Medical Practice
External guidanceand information
You can access these documents when
viewing Good Medical Practice on our
website (www.gmc-uk.org).
1 Paragraph 4 and 21e
Supporting people with long term
conditions to self care: A guide to
developing local strategies and good
practice, Department of Health
(England), 24 February 2006
(www.dh.gov.uk)
Improved self care by people with
long term conditions through self
management education programmes,
British Medical Association,
September 2007
(www.bma.org.uk)
Enabling people with long term
conditions to self manage their
health: a resource for GPs, British
Medical Association, September
2007 (www.bma.org.uk)
Health, Work andWell-being (see
www.workingforhealth.gov.uk)
2 Paragraph 12
National Institute for Health and
Clinical Excellence
(www.nice.org.uk) and NHS Quality
Improvement Scotland
(www.nhshealthquality.org)
3 Paragraph 14e
See appraisal guidance
and information:
Department of Health (England)
appraisal information
(www.dh.gov.uk - see ‘Policy and
Guidance’ section).
Scottish Government:
Consultant Appraisal -
A Brief Guide,
(www.scotland.gov.uk) and
Scottish Government:
Appraisal - A Brief Guide for
Non-Consultant Career Grades
(www.scotland.gov.uk)
General Medical Council 39
Endnotes
Good Medical Practice
Department of Health, Social
Services and Public Safety
(Northern Ireland)
(www.dhsspsni.gov.uk)
Wales appraisal information
and guidance
(http://gp.cardiff.ac.uk)
4 Paragraph 14g
National Patient Safety Agency
(www.npsa.nhs.uk)
5 Paragraph 14h
Medicines and Healthcare products
Regulatory Agency, Yellow Card
Scheme (www.mhra.gov.uk) and
British Medical Association Reporting
Adverse Drug Reactions:
AGuide for healthcare professionals,
May 2006 (www.bma.org.uk)
6 Paragraph 24
The Children Act 2004
(www.opsi.gov.uk)
7 Paragraph 29
When a patient dies: Advice on
developing bereavement services in
the NHS, Department of Health
(England), October 2005
(www.dh.gov.uk)
8 Paragraph 30
Apologies and Explanations, NHS
Litigation Authority, Circular 02/02,
Issued 11 February 2002
(www.nhsla.com)
9 Paragraph 41
Medical Leadership Competency
Framework, NHS Institute, 2008
(www.institute.nhs.uk/
assessment_tool/general/
medical_leadership_
competency_framework_-
_homepage.html)
10 Paragraph 50
Confidentiality: NHSCode of
Practice, Department of Health,
November 2003 (www.dh.gov.uk)
11 Paragraph 63
Medical Certificates and Reports,
British Medical Association, July
2004 (www.bma.org.uk)
40 General Medical Council
Good Medical Practice
12 Paragraph 71c
See research governance frameworks:
ResearchGovernance Framework for
Health and Social Care, Department
of Health (England), 2005
(www.dh.gov.uk)
ResearchGovernance Framework for
Health and Social Care inWales,
WORD, Welsh Assembly
Government, 2001 (new version due
2009) (http://wales.gov.uk/topics/
health/research/word/policy
guidance/resgovernance/
framework/)
ResearchGovernance Framework for
Health and Social Care, R&D Office,
Department of Health, Social
Services and Public Safety
(www.centralservicesagency.com/
display/rdo_research_governance)
ResearchGovernance Framework for
Health and Community Care, Scottish
Executive Health Department, 2006
(www.show.scot.nhs.uk)
13 Paragraph 74
The BlueGuide: Advertising and
Promotion of Medicine in the UK,
Medicines and Healthcare Products
Regulatory Agency, 2005
(www.mhra.gov.uk)
14 Paragraph 78
Guidance for Clinical Health Care
Workers: Protection Against Infection
with Blood-borne Viruses
Recommendations of the Expert
Advisory Group on AIDS and the
Advisory Group on Hepatitis, UK
Health Departments
(www.dh.gov.uk)
General Medical Council 41
Good Medical Practice
Note: Numbers refer to paragraphs.
A
accepting posts 49
access to medical care 7–10
accountability,
when delegating 54
when referring 55
within teams 41
adverse drug reactions 14h
adverse events 30
advertising 60–62
after-care 40, 53
apology 30
appraisal 14e
assessment 2a
audit 14c, 41d
B
bequests 72c
best interests 2c, 74–75
biomedical companies 75
bullying 46
C
care,
access to medical care 7–10
arrangement of cover 48
of those you are close to 5
provision of good quality 2–3
supporting self-care 4, 21e
carers 29
cautions (criminal) 58
children 24 –28, 36
clinical care, characteristics
of good care 2a–c
codes of practice, keeping
up to date with 13
coercion 62, 72d
colleagues,
appraisal of 18
challenging colleagues whose
behaviour does not comply
with guidance 46
conduct and performance of 43
definition 1
information sharing
with 22d, 50–53
support of colleagues
with problems 41e
working in teams 41, 42
working with 41–55
commercial interests 73a
42 General Medical Council
Index
Good Medical Practice
communicable diseases 78
communication,
effective 22a–d
importance in doctor-patient
relationship 20
meeting needs of patient 23
when things go wrong 30–31
with children and
young people 27a–c
within teams 41b
competence,
as teacher 16
continuing education 12
limits of 67
of good doctors 1
recognition of limits 3a
complaints, from patients 31
conduct 57
confidential inquiries 14g
confidentiality 37
patient privacy and right to 21d
formal inquiry 68
relatives, carers and partners 29
conflicts of interest 74–76
consent 36, 72a
continuing education 12–13, 14
contractual notice period 49
convictions, reporting 58
coroner 69
cover, arrangement of 48
criminal offences,
informing the GMC of 58
criticism of colleagues 47
D
death of patient 37, 69
decision-making by patients 21f
delay,
in provision of information 66
in treatment 7
delegation 54
discrimination 7, 46
E
education, continuing 12–14
emergency treatment provision 11
ending appointments 49
ending relationships
with patients 38– 40
F
false and misleading information 65
fees and charges 72a,f
financial arrangements 72–74
financial incentives and conflicts
of interest 74
General Medical Council 43
Good Medical Practice
financial interests 73a, 76
fitness to practice 43–45, 58
formal inquiry, co-operation with 68
G
general practitioner 52–53, 77
gifts 72c, 74
GMC reference number 35
guarantees 61
H
harm 30
harassment 46
health, registration with
general practitioner 77
healthcare providers, financial
interests in 75–76
honesty 18–19, 63– 64, 72
I
identification 35
illness, consulting colleagues on 79
immunisation 78
improper relationships
with patients 32
indemnity schemes 34
independent advice 6
inducements 74
information 36, 50–53, 65
inquiries, co-operation with
formal inquiries 68
insurance 34
integrity 1, 56
investigations, arrangement of 2b
J
judgement, as affected by
personal illness 79
K
keeping up to date 12–14
L
language, meeting needs of
patient 23
laws, keeping up to date with 13
leading a team 42
licensing 14b
litigation 67
locums 18, 49
M
management responsibilities 41c, 45
medical records 3f, 3g, 40
moral beliefs 8, 33
44 General Medical Council
Good Medical Practice
O
off-duty arrangements 48
P
pain, alleviation of 3d
partners 29
patient safety,
colleagues 43
raising concerns on 6
sharing information
with colleagues 50
performance 14, 79
performance reviews 14e
personal beliefs 7, 8, 33, 46
pharmaceutical companies 75
political beliefs 33
prescribing 3b, 3f, 14h
prioritising by clinical need 9
privacy of patient 21d
private treatment 72e
probity 56–76
procurator fiscal 69
professional indemnity cover 34
public health organisations 14i
publishing information 60–62
Q
qualifications 64
quality assurance 14d
quality improvement 14d
R
raising concerns 6, 46
references 19
referral 2c, 51, 55
refusal to treat 8, 10
regulatory bodies 44, 55
relationships,
ending 38–40
improper 32
with colleagues 1, 41–55
with patients 1, 20–40
relatives 29
religious beliefs 7, 8, 33, 46
reports, written 63
research 70–71
respect 7, 46–47
revalidation 14b
risk 6,10,14g,18, 22b, 43, 45, 79
General Medical Council 45
S
second opinion 3e
self-care 4, 21e
self-treatment 77
serious communicable diseases 78
sexual relationships 32
skills, up-to-date 1, 12
student appraisal 18
supervision of staff 17, 42
suspension 59
T
taking up appointments 49
teaching 15–19
teams 22d, 41– 42
training 15–19
treatment,
arrangement 2b
competence 3b
conflict with beliefs 8
refusal 7, 10
U
uncertainty 14f, 22b, 70
unreasonable delay 66
V
violence 38
vulnerable groups 24–28
W
welfare, of children 25
well-being 4, 24
witness 67
Y
young people 24–28, 36
Good Medical Practice
46 General Medical Council
Good Medical Practice
General Medical Council 47
Notes
Good Medical Practice
48 General Medical Council
Notes
London
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Northern Ireland
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Outside the UK telephone: +44(0)161 923 6602
The GMC is a charity registered in England and Wales (1089278) and Scotland (SC037750)
©2006 General Medical Council. Updated March 2009.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval
system, or transmitted, in any form or by any means, electronic, mechanical, photocopying,
recording or otherwise without the prior permission of the copyright owner.
First published: 1995
ISBN: 978-0-901458-24-7
A catalogue record of this book is available from the British Library
Code: GMC/GMP/0510